脑卒中后抑郁及其对神经功能康复的影响

目的:观察脑卒中后抑郁(Post-Stroke Depression,PSD)的发生率和相关因素;探讨选择性5-HT抑制剂对脑卒中后抑郁神经功能康复的影响.方法:选取急性脑脑卒中患者132例(脑梗死78例,脑出血54例),分别在病程2周、1,3,6,12月时给每一位入组患者行PSD诊断、神经功能缺损评分、日常生活能力评分(Activity of Daily Living Scale,ADL)、汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)评分;同时完成Zung's抑郁自评量表(Self-Rating Depression Scale,SDS)和焦虑自评量表(Self-Rating Anxiety Scale,SAS).结果:①脑卒中患者中约44.70%出现抑郁症状;②脑卒中类型和性别与PSD发生率无相关性(P＞0.05);③PSD的发生率和严重程度与神经功能缺损和日常生活能力下降程度有关.④PSD与病变部位、病灶大小、病灶单侧性均无明显相关(P＞0.05);⑤氟西汀抗抑郁治疗能明显改善病程3、6个月时的神经功能缺损,病程12月时不仅抑郁症状减轻,日常生活能力改善,神经功能缺损减轻尤为显著.结论:脑卒中后抑郁是急性脑血管病患者常见的长期并发症,并可影响患者功能康复的速度和程度.抗抑郁剂治疗能在抑郁症状明显改善的同时,促进患者日常生活能力和神经功能的恢复.     

Axonal and myelin lesions inβ-mannosidosis: Ultrastructural characteristics

Summary Ultrastructural changes in central nervous system (CNS) white matter of three goats affected with-mannosidosis were analyzed to further define characteristics and pathogenesis of axonal and myelin abnormalities. The variations in myelin association and contents of axonal spheroids were delineated. The occurrence of spheroids in a 96/150-day fetus documented the early development of these axonal lesions. In regions of severe myelin deficits, the presence of apparently normal axons and a reduction in the number of oligodendrocytes were confirmed. Many remaining cells in myelin-deficient regions were characterized by dark, vacuolated cytoplasm. The occurrence of internodes with myelin sheaths adjacent to internodes without myelin sheaths suggested that an axonal defect is not primarily responsible for the absence of myelin sheaths. A mild myelin deficit in the spinal cord was indicated by the presence of unmyelinated axons. Except for occasional mild cytoplasmic vacuolation, the spinal cord glial cells appeared relatively normal. The findings presented here are consistent with the hypothesis that an oligodendrocyte defect, expressed by regional differences, is a major factor in the pathogenesis of myelin deficiency in-mannosidosis.Supported by NIH grant NS-16886 to MZJ and BRSG funds from the College of Osteopathic Medicine, Michigan State University, to KLL     

Tardive dyskinesia in schizophrenics. Prevalence, distribution and relationship to neurological "soft" signs in Nigerian patients

The prevalence of tardive dyskinesia (TD) in 70 Nigerian schizophrenics was 37%. Age was related to the presence of TD in males but not in females. Significantly more females had TD in the lower extremities. Comparison of patients with TD and those without revealed no significant differences with regard to the presence of neurological "soft" signs.     

Differential effects of sympathetic activity on AV junctional automaticity and AV conduction

Summary Rapid ventricular response during episodes of supraventricular tachycardia are often followed, on abrupt cessation of the tachycardia, by prolonged pauses terminated by a sluggish and sometimes erratic escape of a supraventricular pacemaker. Such chronotropic-dromotropic paradoxes are readily reproduced in the animal laboratory following elimination of the sinus node and bilateral decentralization of the stellate ganglia and vagi. This study examined whether left stellate stimulation (0.5, 1, 2, 4, 8 and 16 Hz) or lack thereof differentially affected AV junctional automaticity and AV conduction. In the absence of any sympathetic neural activity (maximal sympathetic deficit), the AV junctional rate averaged a mere 22±2 percent of its peak performance, whereas under the same conditions, anterograde AV conduction averaged 73±5 percent and retrograde VA conduction 56 ±13 percent of their respective peak performances. On comparing the response curve (normalized responses) for AV junctional automaticity with that obtained for anterograde AV conduction the differences were significant at all frequencies between 0 and 4 Hz. Retrograde VA conduction (as assessed by the fastest ventricular pacing rate still conducted 11 to the atria) was always significantly less than anterograde AV conduction (as assessed by the fastest atrial pacing still conducted 11 to the ventricles). These results indicate that AV junctional automaticity is considerably more affected by sympathetic deficit than are either anterograde or retrograde AV conduction. In other words, AV junctional automaticity is far more dependent upon sympathetic input than AV conduction. While sympathetic influence is critical to the escape and maintenance of AV junctional automaticity both anterograde and retrograde AV conduction are remarkably resilient even under conditions of severe sympathetic deficit.     

Effect of maternal cadmium exposure on postnatal development and tissue cadmium,copper and zinc concentrations in rats

Administration of 60 ppm cadmium (Cd) in drinking water from the 1^st to the 20^th day of gestation to female rats did not affect the viability, body weight gain, food, and water consumption of offspring. The blood hemoglobin level was reduced in 2-week-old females and males but not in 16-week-old offspring. Hematocrit and serum glucose level were not affected at either age. Cadmium concentration in the intestinal wall was increased in both age groups, with marginal uptake in other organs. A decrease in copper (Cu) concentration was found in the brain of 2-week-old offspring of both sexes and of 16-week-old females. The brain zinc (Zn) concentration was decreased only in 16-week-old animals. The physical and neuromuscular development of offspring before weaning was not impaired by maternal Cd treatment. The alterations in Cu and Zn metabolism were associated with reduced locomotor activity and affected open-field behavior in adult offspring of either sex and with decreased avoidance acquisition in adult female offspring.The results obtained suggest a relationship between the reduced brain Cu and Zn levels and CNS dysfunction in adult offspring of female rats exposed to Cd during gestation.     

儿童注意缺陷多动障碍个性及智力特征探讨

目的 :了解注意缺陷多动障碍 (ADHD)儿童的个性及智力特点。方法 :采用艾森克个性问卷 (EPQ)和韦氏儿童智力量表 (WISC R)对 40例ADHD患儿进行测试。结果 :ADHD组EPQ测验中神经质和精神质量表T分高于正常对照组 ,掩饰性量表T分低于正常对照组。WISC R测验中 ,ADHD组总智商 (FIQ)在正常范围 ,但与正常对照组比较有显著性差异(P <0 .0 5 )。在言语智商 (VIQ)与操作智商 (PIQ)平衡上 ,ADHD组的算术、理解、译码分测验量表分较正常组低 ,两组比较有显著性差异。结论 :ADHD儿童情绪稳定性差 ,心理成熟能力延迟 ,同时可能存在言语理解、记忆 /不分心因子缺陷     

观察脊柱脊髓损伤不同时间段手术的术后神经功能恢复情况

目的对脊髓损伤患者不同时间段尽早急诊手术的术后神经功能康复情况进行观察。方法选取35例脊柱脊髓损伤并进行创伤外科急诊手术治疗患者的临床资料,进行统计并分析比较其不同时间段进行手术,术后的神经功能康复情况。结果 35例患者术后神经功能恢复均较术前明显好转,8小时手术的患者神经功能康复较8小时的患者好,越早进行手术的患者神经功能康复越好,所有患者术后的脊髓功能ASIA评分(针刺觉评分、轻触觉评分、运动评分)均较术前提高,且时间越早手术的术后ASIA评分提高值就越高,与术前、不同时间段之间比较P0.05,差异具有统计学意义。结论对于脊髓损伤的患者需加快其院外及院内的抢救,以最大限度降低患者的损伤,提高其术后神经功能康复力。     

脑梗塞患者脑脊液中氨基酸代谢研究

采用高效液相色谱法测定脑梗塞患者脑脊液中的 15种氨基酸 ,同时测定脑梗塞体积 ,并对神经功能缺损程度进行评分。结果表明 :脑梗塞组天冬氨酸、谷氨酸均较对照组显著性增高 (分别为P <0 .0 1,P <0 .0 5 ) ;γ 氨基丁酸较对照组显著降低 (P <0 .0 5 ) ,此外 ,丙氨酸和亮氨酸较对照组亦明显升高 (分别为P <0 .0 1,P <0 .0 5 )。天冬氨酸、谷氨酸水平与脑梗塞体积呈正相关 (分别r天 =0 .5 6 ,P <0 .0 5 ;r谷 =0 .5 2 ,P <0 .0 5 ) ;所有氨基酸与神经功能缺损程度相关性不明显。本文结果提示 ,兴奋性氨基酸在脑梗塞中参与了神经损害作用 ,而抑制性氨基酸是否具有保护作用值得进一步研究     

脑梗死患者急性期血小板膜糖蛋白表达的研究

目的　探讨脑硬死患者急性期血小板膜P -选择素 (CD6 2p)的表达及其与临床神经功能缺损程度的关系。方法　用流式细胞术测定 41例急性期脑梗死患者血小板膜CD6 2 p的表达。 结果　轻、中、重型脑梗死患者CD6 2 p的表达分别为 (1.38± 0 .2 9) %、(3.15± 1.5 8) %、(10 .46± 5 .0 7) % ,与正常对照组 (1.5 6± 0 .17) %比 ,轻型脑梗死患者CD6 2p的表达无显著性差异 (P >0 .0 5 ) ,中、重型脑梗死患者CD6 2 p的表达显著升高 (P <0 .0 5和0 .0 1)。结论　脑梗死患者急性期血小板膜CD6 2 p的表达与临床神经功能缺损程度有关。